Liver transplantation is an accepted therapeutic modality for complications of chronic liver disease or acute liver failure. In general, liver transplantation is recommended when a patient with end-stage liver disease manifests signs and symptoms of hepatic decompensation, not controlled by alternative therapeutic measures. This is evidenced by the following:
- esophageal and/or gastric variceal bleeding, or bleeding from portal hypertensive gastropathy
- hepatic encephalopathy
- spontaneous bacterial peritonitis
- significant ascites, hepatic hydrothorax or hepatorenal syndrome
- coagulopathy
- liver cancer
- fulminant (acute) liver failure
Evaluation and selection of patients for transplantation is the result of a multidisciplinary coordinated process which assesses the patient holistically. This includes evaluation by a surgeon, hepatologist, transplant coordinator, social worker, and psychiatrist. Patients and their families participate in transplant education during which the surgery, pre- and post-operative care, medications, and long-term follow-up are discussed. Options for liver transplantation, incuding deceased donor and liver donor liver transplantaion, are also discussed with patients and families.